Military-civilian residential segregation and military member psychological distress in Kentucky counties

Abstract

The objective of this study was to estimate and map the distribution of veteran psychological distress (PD) in Kentucky counties and examine the relationship between veteran PD prevalence rates and military-civilian residential segregation (MCRS) in Kentucky counties. We used data from the 2016 National Survey of Drug Use and Health to conduct small area estimation of the prevalence of PD among military veterans in Kentucky’s 120 counties. MCRS was calculated in each county using Wong’s (J Urban Geography 20(7):635–647, 1999) deviational ellipse. We examined the relationship between veteran PD prevalence and MCRS in Kentucky counties using multiple linear regression. Results showed that the average indirect synthetic estimate of PD in Kentucky was 5.027%, however, we observed substantial geographic variation in these rates. After controlling for county-level covariates, counties with greater MCRS had an increase in veteran PD prevalence, b = 0.547 (95% CI 0.051, 0.983). Rural health care and public health practitioners may need to become more cognizant of patients’ veteran status and sensitized to risk factors that alert them to responsive treatment options and referrals to applicable evidence-based interventions.